NPIMap

Organization Active NPI

Reconstructive Foot and Ankle Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Frederick, MD
National Provider Identifier
1245610476
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
01333 Issued in MD
Legal business name
RECONSTRUCTIVE FOOT AND ANKLE INSTITUTE, LLC
Practice address
2100 Old Farm Dr
Suite D
Frederick, MD 21702-9494
Phone
(301) 418-6014
Fax
(301) 797-8554
NPI assigned
Jun 3, 2015
Last updated
Jun 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel D Michaels, DPMNPI 1073615373
Title
Podiatrist/Member
Phone
(301) 797-8554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 01333 MD Primary

Addresses

Primary practice location

2100 Old Farm Dr
Suite D
Frederick, MD 21702-9494

Mailing address

1150 Professional CT
Suite C
Hagerstown, MD 21740-4100
Phone (301) 797-8554

Other identifiers 1

IdentifierTypeStateIssuer
403918100MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Reconstructive Foot Ankle Institute LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1245610476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PROFESSIONAL CT",
            "address_2": "SUITE C",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404100",
            "telephone_number": "301-797-8554",
            "fax_number": "301-797-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 OLD FARM DR",
            "address_2": "SUITE D",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217029494",
            "telephone_number": "301-418-6014",
            "fax_number": "301-797-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONSTRUCTIVE FOOT AND ANKLE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PODIATRIST/MEMBER",
        "authorized_official_telephone_number": "301-797-8554",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "01333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403918100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.